The cyclospora outbreak that has swept the country since spring is no joke. The outbreak, linked at least in part to lettuce, has infected at least 18,000 — likely many more — and killed two. But this hasn’t stopped influencers from posting before-and-after cyclospora-induced weight loss pictures, and videos of strawberries with the captions “When you need to lose the last 10 lbs” and “Cyclosporiasis it’s all you baby!” This is all part of a trend known as “Parasite-Maxxing” or “Cyclospora Skinny.”
Cyclospora wasn’t the only outbreak that got the clinically online treatment this year. There was also a cryptocurrency, made to mock hantavirus, called $Hanta, which spiked in value, reaching an $18 million valuation.
Disease jokes aren’t the aberration — they’re part of how public health travels online. As health information and entertainment increasingly converge on the same online platforms, they start to blend. For young people, the collision of humor, entertainment and disease on social media creates the risk for offensive and harmful memes that can cause real damage. But experts say that collision also creates a massive opportunity for increasing awareness and understanding of disease outbreaks.
According to a recent Pew Research study, over a third of Americans get health information on social media, with youth being especially likely to do so. Research Director at UPenn’s Annenberg Public Policy Center, Dan Romer, said many teens turn to social media based on precedent. “If they’ve had exposure to an influencer in the past,” Romer said, “they’ll go there.”
But even when a teen isn’t looking for health information online, it may end up on their screens. “Algorithms are tuned to respond to people’s interests,” said Romer, “content immediately goes to people who show any signs of an interest in it.” That extends to health topics. For instance, he said, “If you show any signs of mental health problems, an algorithm will start giving you information about depression, possibly suicide.”
Young people increasingly turned to social media for health info during the COVID-19 pandemic. That’s also when public health information traveling there increasingly got politicized and contradictory. While then-Director of the National Institute of Allergy and Infectious Diseases Anthony Fauci and other public health officials called for masking and social distancing as mitigation strategies, President Donald Trump negated their advice. Trump called hydroxychloroquine a “game-changer” treatment for COVID. Further, Trump ostracized Fauci and called him a Democrat, when in fact he is an Independent.
University of Minnesota Professor Rebekah Nagler argued this amount of politicization and contradictory information had adverse effects on teens, who came of age scrolling through endless mixed signals about a major public health crisis.
Nagler, who teaches in the Hubbard School of Journalism and Mass Communication at the University of Minnesota, said that in the studies she has done on contradiction and politicization, “We see more exposure to conflicting health information being associated with greater confusion, decreased trust, backlash towards research and recommendations, and less adherence to recommended behaviors.” She then witnessed the same negative impacts during COVID. “I think it makes sense that politicization happened, but the way that it happened wound up being deeply problematic,” she said.
She has seen the general public’s mistrust of science and health-related confusion continue post-pandemic, and she thinks the same thing will play out again in future outbreaks. “I have no reason to believe that responses would be any different in the future,” said Nagler.
One potentially negative impact of many hantavirus and cyclospora memes that circulated this year is that they over-inflate the risk to the public by drawing unrealistic parallels to the COVID-19 pandemic that could cause panic if taken literally. In a post emblematic of many others, one X user wrote that it was “time to stock up on toilet paper again.”
Offensive and demeaning jokes also permeate the internet during major disease events. Take, for example, the 2022 mpox outbreak. Online influencers and mememakers labeled mpox in 2022 as a gay disease, suggesting (very erroneously) that straight marriage was the only solution.
In a 2024 study, researchers at the Chinese University of Hong Kong, the University of Arizona, and the University of Michigan found one in four toxic mpox tweets from the 2022 outbreak were homophobic.
A 2022 study also identified stigmatization as a result of social media posts about mpox, along with other negative impacts. Qin Xiang Ng and other researchers at the National University of Singapore utilized machine learning to analyze 352,182 Twitter posts about the outbreak. The model found multiple recurring themes, including “stigmatization of minority communities, and a general lack of faith in public institutions.”
But humor and public health aren’t always a terrible duo. Sometimes, they can help people process a terrifying disease outbreak and create communal responses to serious problems.
“Just because something’s humorous doesn’t mean it’s transmitting misinformation,” said Romer. In fact, he said, “If someone can make a joke about something in a way that leads the user to take precautions or be healthier, that’s a very good strategy.” Romer added that humor’s inherently light nature makes it easier to process.
Jessica Willoughby, a communications professor at Washington State University, called humor “beneficial as a foundation.” “Even if the humor is blowing it out of proportion, it is still bringing an awareness that may not have been present before,” she said.
Willoughby studied Tom Hanks as an example of how public health interacts with the internet. Specifically, she studied people’s reactions to Tom Hanks getting COVID-19 early in the pandemic as a moment when public health and entertainment collided. She found people were more willing to take preventive action after learning of Hanks’s diagnosis. This is an example of what she calls parasocial relationships.
“People don’t want to feel like they’re being manipulated online, so they’re looking for someone they think they could be friends with in real life,” Willoughby said. “If you feel a level of connection with a public figure, you’re more likely to seek out other information about the health topic.” This means that public figures can make someone more conscious and more likely to find and share accurate and beneficial health information.
Romer said there’s a “contagious effect” with content-sharing in social and parasocial settings. “You see they’re doing things you may not have done before. You’re more likely to say, ‘I should try it.’ It makes the behaviour more acceptable, more normative.” So, positive health behaviors during an outbreak, if a trusted entertainer or influencer shares them, can become the norm pretty quickly.
This all comes with an important caveat. Romer said social media is “like going to a party where everybody’s been drinking.” In other words, there is all sorts of information out there — good and crazy. So, it really matters whether the parasocial figure is sharing accurate information.
Willoughby called social media a testing ground for teens’ social identities; it can potentially prime them for positive behaviors. “It might not even be intentional, but it might tie back to societal norms or things like that that could then later impact behaviors and attitudes,” she said. Subconsciously, Willoughby said people ask, “Is this behavior desirable, right? Am I the type of person who should be engaging in this?”
Given that the content resulting from the mixing of entertainment and public health is so murky, the solution is — in part — prudent fact-checking, according to Nagler. She said that being smart online involves a lot of sleuthing and recommends users constantly ask themselves, “Where is this information coming from? Who are they citing? Can I track that? If I see their primary source is a CDC report, can I click through and verify that?”
And just as important to remember: Science is not static, so truth can evolve — and that shouldn’t erode trust. Nagler said, “Just because something is true now doesn’t mean it will always be true. Science does evolve, and our understanding of health phenomena can change.”
No one can stop health information from being on social media, so the solution probably isn’t to tear it apart. Instead, users can take experts’ advice to learn when a joke is just a joke and not factual, when it is harmful, and when it can actually be helpful.
